The Cancer Pain Interventions Service is a dedicated team that provides pain management to patients who have pain related to cancer or cancer treatment. While other teams may address cancer pain with medications, our team takes an interventional approach that may involve injections or procedures to help reduce pain. 

Our aim is to reduce pain and improve quality of life for a range of patients, including some cancer survivors, patients living with cancer as a long-term condition, or patients no longer having treatment for their condition. Although we do assess patients who are approaching the end of their life, many of our interventions may be appropriate earlier in a patient's journey and so we encourage early referrals. 

We offer a range of interventions, including advanced procedures like intrathecal pump implants, percutaneous cervical cordotomy and intrathecal neurolysis procedures.

Referral pathway 

Most specialist cancer pain referrals are made by our colleagues in palliative medicine or oncology. Further information can be found under referral information. 

What we offer 

Patients who are referred to our service are assessed by one of our specialist nurses or consultants. A typical assessment will cover several core areas: 

  • History of pain and its effect on function, wellbeing and quality of life 
  • General medical history 
  • Investigations, treatments and interventions already received for cancer 
  • Medication history 
  • Prognosis and outlook 

Following this an individualised plan will be made on how to proceed and may include: 

  • Advice 
  • Medication changes 
  • Interventions 
  • Further investigations 
  • Referral to another specialist or centre 

The outcome of this will be explained during the consultation and will be documented in the medical records. A copy of the clinic record will be sent to the GP. 

We also offer specialist advice to colleagues in palliative medicine and oncology and attend regular multidisciplinary team meetings. 

We offer a range of interventions from simple injections through to complex implantable devices, such a spinal cord stimulators and intrathecal pumps. Our choice of intervention and/or injection will follow national guidance and commissioning pathways and will be individualised to each patient, based on the nature and cause of their pain, prognosis, medical comorbidities and potential risks. 

Here is a list of some of the common interventions we offer: 

  • Simple spinal injections 
  • Ultrasound-guided nerve blocks 
  • Thermal radiofrequency denervation 
  • Pulsed radiofrequency treatment 
  • Sympathetic nerve block of stellate ganglion or coeliac plexus, lumbar plexus or ganglion impar 
  • Neurolytic injections 
  • Intrathecal drug delivery systems 
  • Qutenza (capsaicin) patch therapy 

This list is not exhaustive and more interventions may be offered if appropriate.

Patient information leaflets on many of these procedures are available from the Faculty of Pain Medicine website. 

Intrathecal pumps offer a mechanism of delivering pain relief directly into the intrathecal (spinal) space which is located around the spinal cord. This allows the delivery of strong painkillers in smaller amounts as well as local anaesthetic to numb painful areas. 

The intrathecal pump consists of a plastic catheter connecting the spinal space to a drug reservoir and a programmable pump which is surgically implanted in the abdomen. 

These pumps have the ability to provide background infusions and also bolus doses for breakthrough pain relief.